Excerpt

"Surgical Treatment – Evidence-Based and Problem-Oriented" is based upon a concept which the
editors believe will become increasingly important in the preparation of clinical textbooks in the 21st
century, namely the quality of the evidence upon which currently accepted clinical practice is based
needs to be assessed frankly and taken into account when recommendations for patient treatment
are made. As is apparent in many of the chapters in this volume, the authors are frequently forced to
conclude that a higher level of evidence than is currently available would be necessary in order establish
the validity of the currently accepted management of a wide variety of common surgical problems. The editors
believe this is a fact of which both students and surgical practitioners need to be aware, so that they may be
prepared to update and alter their clinical decision making on the basis of higher levels of evidence when
these become available. The editors also hope that increasing awareness of the low level of evidence upon
which much present day surgical practice is based will prompt surgeons from many countries to plan or at
least participate in clinical trials to achieve a higher quality of evidence upon which to base a more rational
clinical practice.

Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone).